别为此事失眠：晚期肌萎缩侧索硬化症患者夜间植入式脑机接口的功能
DO NOT LOSE SLEEP OVER IT: IMPLANTED BRAIN-COMPUTER INTERFACE FUNCTIONALITY DURING NIGHTTIME IN LATE-STAGE AMYOTROPHIC LATERAL SCLEROSIS.
作者信息
Leinders Sacha, Aarnoutse Erik J, Branco Mariana P, Freudenburg Zac V, Geukes Simon H, Schippers Anouck, Verberne Malinda S W, van den Boom Max, van der Vijgh Benny, Crone Nathan E, Denison Timothy, Ramsey Nick F, Vansteensel Mariska J
机构信息
UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, the Netherlands.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA.
出版信息
medRxiv. 2024 Oct 15:2024.10.11.24315027. doi: 10.1101/2024.10.11.24315027.
BACKGROUND AND OBJECTIVES
Brain-computer interfaces () hold promise as augmentative and alternative communication technology for people with severe motor and speech impairment (locked-in syndrome) due to neural disease or injury. Although such BCIs should be available 24/7, to enable communication at all times, feasibility of nocturnal BCI use has not been investigated. Here, we addressed this question using data from an individual with amyotrophic lateral sclerosis (ALS) who was implanted with an electrocorticography-based BCI that enabled the generation of click-commands for spelling words and call-caregiver signals.
METHODS
We investigated nocturnal dynamics of neural signal features used for BCI control, namely low (: 10-30Hz) and high frequency band power (: 65-95Hz). Additionally, we assessed the nocturnal performance of a BCI decoder that was trained on daytime data by quantifying the number of unintentional BCI activations at night. Finally, we developed and implemented a nightmode decoder that allowed the participant to call a caregiver at night, and assessed its performance.
RESULTS
Power and variance in HFB and LFB were significantly higher at night than during the day in the majority of the nights, with HFB variance being higher in 88% of nights. Daytime decoders caused 245 unintended selection-clicks and 13 unintended caregiver-calls per hour when applied to night data. The developed nightmode decoder functioned error-free in 79% of nights over a period of ±1.5 years, allowing the user to reliably call the caregiver, with unintended activations occurring only once every 12 nights.
DISCUSSION
Reliable nighttime use of a BCI requires decoders that are adjusted to sleep-related signal changes. This demonstration of a reliable BCI nightmode and its long-term use by an individual with advanced ALS underscores the importance of 24/7 BCI reliability.
TRIAL REGISTRATION
This trial is registered in clinicaltrials.gov under number NCT02224469 (https://clinicaltrials.gov/study/NCT02224469?term=NCT02224469&rank=1). Date of submission to registry: August 21, 2014. Enrollment of first participant: September 7, 2015.
背景与目的
脑机接口（BCI）有望成为因神经疾病或损伤导致严重运动和言语障碍（闭锁综合征）患者的辅助和替代通信技术。尽管此类脑机接口应能全天候使用，以便随时进行通信，但尚未对夜间使用脑机接口的可行性进行研究。在此，我们利用一名肌萎缩侧索硬化症（ALS）患者的数据解决了这个问题，该患者植入了基于皮层脑电图的脑机接口，能够生成用于拼写单词的点击命令和呼叫护理人员信号。
方法
我们研究了用于脑机接口控制的神经信号特征的夜间动态变化，即低频（LF：10 - 30Hz）和高频带功率（HFB：65 - 95Hz）。此外，我们通过量化夜间无意的脑机接口激活次数，评估了在白天数据上训练的脑机接口解码器的夜间性能。最后，我们开发并实现了一种夜间模式解码器，使参与者能够在夜间呼叫护理人员，并评估了其性能。
结果
在大多数夜晚，HFB和LFB的功率及方差在夜间显著高于白天，88%的夜晚HFB方差更高。当将白天的解码器应用于夜间数据时，每小时会产生245次无意的选择点击和13次无意的呼叫护理人员操作。在±1.5年的时间里，开发的夜间模式解码器在79%的夜晚无差错运行，使用户能够可靠地呼叫护理人员，无意激活仅每12个夜晚发生一次。
讨论
可靠的脑机接口夜间使用需要针对与睡眠相关的信号变化进行调整的解码器。这种可靠的脑机接口夜间模式及其在晚期ALS患者中的长期使用证明强调了全天候脑机接口可靠性的重要性。
试验注册
本试验已在clinicaltrials.gov上注册，编号为NCT02224469（https://clinicaltrials.gov/study/NCT02224469?term=NCT02224469&rank=1）。提交注册日期：2014年8月21日。第一名参与者入组日期：2015年9月7日。
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